Tammy Jo Coletta

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0005606 Issued in CO

Practice address

8422 N 123Rd East Ave
Owasso, OK 74055-2130

Phone

(918) 858-4353

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pine Ridge Mental Healthcare, LLCGroup PAC ID 2062812043, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pine Ridge Mental Healthcare, LLC

  • Psychiatry Physician
  • Owasso, OK
  • NPI 1346828050

  Mental Health

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1376766972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 N 123RD EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552130",
            "telephone_number": "918-858-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8422 N 123RD EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552130",
            "telephone_number": "918-858-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLETTA",
        "first_name": "TAMMY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0005606",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CLPS, LLC
• Rosetta Cody
• Morgan Coldwell, APRN
• Jessica Cole, COTA
• Elizabeth J Coleman, SLP
• Joshua Collins, COTA/L
• Kassidy Collins
• Sedric D Collins
• Debra Sue Colpitt, M.D.
• Bryce Cameron Colt, DC

• Professional Counselor in Owasso, OK
• Providers in Owasso, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.